CA-125: What does that lab really mean?
-
Roma Patel
,
Matthew Armfield
Abstract
Ovarian torsion is often a diagnosis of exclusion, and while less common in pre-pubertal females, it is on the differential for a pelvic mass. Tumor markers can be used to characterize a pelvic mass, with varying sensitivity and specificity. This is a case of a 10-year-old pre-pubertal female presenting with abdominal pain and found to have an ovarian mass. Her tumor markers demonstrated an elevated CA-125, increasing concern for neoplasm. This led to a delayed operative course and she was ultimately found to have an ovarian torsion. There is unclear utility of CA-125 in pediatrics and reliance on tumor markers during the work-up of an ovarian mass should be limited to avoid diagnostic error.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Taskinen S, Fagerholm R, Lohi J, Taskinen M. Pediatric ovarian neoplastic tumors: incidence, age at presentation, tumor markers and outcome. Acta Obstet Gynecol Scand 2015;94:425–9.10.1111/aogs.12598Search in Google Scholar
2. Papic JC, Finnell SM, Slaven JE, Billmire DF, Rescorla FJ, Leys CM. Predictors of ovarian malignancy in children: overcoming clinical barriers of ovarian preservation. J Pediatr Surg 2014;49:144–8.10.1016/j.jpedsurg.2013.09.068Search in Google Scholar
3. Galinier P, Carfagna L, Delsol M, Ballouhey Q, Lemasson F, Le Mandat A, et al. Ovarian torsion. Management and ovarian prognosis: a report of 45 cases. J Pediatr Surg 2009;44:1759–65.10.1016/j.jpedsurg.2008.11.058Search in Google Scholar
4. Spigland N, Ducharme JC, Yazbeck S. Adnexal torsion in children. J Pediatr Surg 1989;24:974–6.10.1016/S0022-3468(89)80195-2Search in Google Scholar
5. Ashwal E, Hiersch L, Krissi H, Eitan R, Less S, Wiznitzer A, et al. Characteristics and management of ovarian torsion in premenarchal compared with postmenarchal patients. Obstet Gynecol 2015;126:514–20.10.1097/AOG.0000000000000995Search in Google Scholar PubMed
6. Chang Y-J, Yan D-C, Kong M-S, Wu C-T, Chao H-C, Luo C-C, et al. Adnexal torsion in children. Pediatr Emerg Care 2008;24:534–7.10.1097/PEC.0b013e318180fd8bSearch in Google Scholar PubMed
7. Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion-a 15-year review. J Pediatr Surg 2009;44:1212–7.10.1016/j.jpedsurg.2009.02.028Search in Google Scholar PubMed
8. McCarthy JD, Erickson KM, Smith YR, Quint EH. Premenarchal ovarian torsion and elevated CA-125. J Pediatr Adolesc Gynecol 2010;23:e47–50.10.1016/j.jpag.2009.04.002Search in Google Scholar PubMed PubMed Central
9. Miralles C, Orea M, España P, Provencio M, Sánchez a, Cantos B, et al. Cancer antigen 125 associated with multiple benign and malignant pathologies. Ann Surg Oncol 2003;10:150–4.10.1245/ASO.2003.05.015Search in Google Scholar
10. Moss EL, Hollingworth J, Reynolds TM. The role of CA125 in clinical practice. J Clin Pathol 2005;58:308–12.10.1136/jcp.2004.018077Search in Google Scholar PubMed PubMed Central
11. Romagnolo C, Leon AE, Fabricio AS, Taborelli M, Polesel J, Del L, et al. Gynecologic oncology HE4, CA125 and risk of ovarian malignancy algorithm ( ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: an Italian multicenter study. Gynecol Oncol 2016;141:303–11.10.1016/j.ygyno.2016.01.016Search in Google Scholar PubMed
©2016 by De Gruyter
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Articles in the same Issue
- Frontmatter
- Opinion Paper
- Healthcare is a giant with feet of clay
- Original Articles
- Diagnosis is a team sport – partnering with allied health professionals to reduce diagnostic errors
- An investigation into method of diagnosis in clinicopathologic conferences (CPCs)
- Primary care pediatricians’ interest in diagnostic error reduction
- Spurious elevation of serum potassium concentration measured in samples with thrombocytosis
- Mobile phone exposure influences some erythrocytes parameters in vitro. A novel source of preanalytical variability?
- Case Reports
- Those eyes don’t lie: a case of osmotic demyelination syndrome in a patient with hepatic encephalopathy
- CA-125: What does that lab really mean?
- Letter to the Editor
- Assessment of reticulated platelets with automated hemocytometers: are we measuring the same thing?
- Congress Abstracts
- Diagnostic Error in Medicine 1st European Conference June 30–July 1, 2016
